The Neurosurgical Society of Australasia’s guidelines recommend that if patients are more than two hours from a neurosurgical centre and have clinical or computed tomography (CT) signs of increased intracranial pressure (ICP), then non-neurosurgeons should perform surgical decompression of TBIs. No reviews to date examine non-neurosurgeons’ performance of neurosurgical interventions for patients with increased ICP secondary to a TBI in these non-metropolitan settings. A scoping review about emergency neurosurgical interventions performed by a non-neurosurgeon for TBIs in non-metropolitan settings without prompt access to a neurosurgeon yielded 20 studies and included over 2000 surgical interventions in 13 countries. General surgeons most commonly performed the procedures on patients with CT-confirmed lesions. Burr holes were the most common procedure, with most surgeries having remote neurosurgeon advice via telecommunications. Mortality rates were heterogenous in small cohorts with variable follow-up periods, but consistently higher in patients with subdural haematomas (SDHs) opposed to extradural haematomas (EDHs). Morbidity was measured in 13 studies, commonly via the Glascow Outcome Scale (GOS). Identifying evidence of the success of these interventions by non-neurosurgeons may highlight the importance of providing non-metropolitan centres and staff with the capability and resources to surgically decompress TBIs.

Purpose:
Ectopic papillary thyroid carcinoma (PTC) is rare and typically managed surgically. This case involves a 32-year-old woman with an 8-month history of a left neck lump. Imaging revealed a thyrohyoid cyst. She underwent transoral robotic surgery (TORS) for cyst removal. Intraoperatively, the lesion contained a cystic and adjacent solid component. Histopathology confirmed ectopic PTC, fully excised. A total thyroidectomy showed no residual disease. The case was discussed at a multidisciplinary meeting, and the patient received postoperative radioactive iodine therapy.

Methods:
A literature review was conducted on the use of TORS for ectopic PTC.

Results:
Ectopic thyroid carcinoma represents 0.3–0.5% of all thyroid cancers and has been identified in thyroglossal duct cysts, lateral neck, and occasionally in thyrohyoid cysts. All reported cases were treated surgically, usually followed by radioactive iodine. No previous cases of TORS for ectopic PTC were identified.

Discussion:
This is the first reported case of ectopic PTC within a thyrohyoid cyst successfully managed using TORS. It highlights a minimally invasive surgical option for rare thyroid malignancies. The case reinforces the value of multidisciplinary decision-making and the importance of considering varied surgical approaches in managing ectopic thyroid disease.

Purpose:
Hyalinising clear cell carcinoma (HCCC) is a rare salivary gland malignancy, seldom found at the base of tongue (BOT). This case describes an aggressive, poorly differentiated HCCC initially misdiagnosed as p16-positive squamous cell carcinoma (SCC).

Methods:
A 56-year-old male smoker presented with several months of sore throat and dysphagia. Initial biopsy indicated p16-positive BOT SCC, and he was treated with definitive chemoradiotherapy. Due to poor response, the case was reviewed in a head and neck multidisciplinary meeting (MDM). The patient then underwent total glossectomy, total laryngectomy, bilateral neck dissection, and local reconstruction. Final histopathology revealed poorly differentiated HCCC with EWSR1 gene rearrangement, nodal metastases, and skeletal invasion. A literature review was conducted to explore oropharyngeal HCCC characteristics.

Results:
HCCC accounts for roughly 1% of salivary gland malignancies and is typically low-grade. Literature reports a 25% rate of nodal involvement. While misdiagnosis of pulmonary HCCC as SCC has been documented, this is the first reported case of oropharyngeal HCCC initially identified as SCC.

Conclusion:
This case highlights the critical role of histopathological review in non-responding or atypical head and neck cancers. HCCC can mimic SCC and demonstrate aggressive features, emphasizing the need for multidisciplinary evaluation and consideration of rare diagnoses.

This report is a case study review of two cases of Sago haemolytic disease. Sago haemolytic disease (SHD) is a rare but significant condition presenting in sago starch-eating populations in low-land regions of Papua New Guinea and resulting from the consumption of stale or improperly stored sago.
This paper reflects on the clinical presentations for early recognition. And also, on clinical management of such cases in remote rural health facilities. More importantly, mentioning certain observed factors contributing to the severity of the diseases.
An as there is currently no known antidote, nor is there a standardized national treatment protocol, this paper may serve as education for clinicians working with Sago consuming communities; hence, will be aware of the signs and symptoms of SHD. While advanced supportive care may be required in severe cases, including blood transfusion and dialysis, initial management including fluid resuscitation and close fluid monitoring can be effectively carried out in well-equipped rural health facilities.

Depression frequently co-occurs with chronic conditions such as cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM), complicating clinical management and increasing healthcare needs—especially in rural settings with limited healthcare access. This study examines these associations using a large Australian primary care dataset and explores how they vary across urban, regional, and rural areas—an often-overlooked aspect in mental–physical health research. A key strength of this study is the use of three distinct depression definitions (‘depression only’, ‘mixed anxiety and depression’, and ‘any depression’), offering a nuanced understanding of comorbidity patterns.
A cross-sectional analysis was conducted using de-identified patient data from general practices across Australia, sourced via the PenCS CAT4 Clinical Audit Tool. Depression, CVD, and T2DM were defined using diagnosis and medication records. Multivariable logistic regression models were used to estimate associations.
Findings revealed consistent associations between ‘depression only’ and ‘any depression’ with both CVD and T2DM. Regional areas showed lower T2DM odds than urban, while rural areas showed higher odds than regional—indicating complex geographic variation. These results support the development of tailored, integrated care strategies in rural general practice to improve outcomes for patients with depression and chronic disease, particularly in rural Australia.